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Profile: Ezekiel Emanuel

Ezekiel Emanuel was a participant or observer in the following events:

Betsy McCaughey, the former lieutenant governor of New York and a lobbyist for the health care industry, writes two frightening op-eds, one for the Wall Street Journal and one for the New York Post, that make false claims about the Democrats’ health care reform package. In the Journal, she claims that the bill contains a provision that would “pressure the elderly to end their lives prematurely,” a claim she has made before (see July 16, 2009). In the Post, she goes much farther, claiming that two of President Obama’s top health care advisers favor denying expensive health care treatments to senior citizens, the mentally disabled, and other “less productive” members of American society. She names Ezekiel Emanuel, a bioethicist, the health care adviser at the White House’s Office of Management and Budget (OMB), and a member of the Federal Council on Comparative Effectiveness Research. She cites a 2008 article by Emanuel in the American Medical Association’s journal, where he wrote that some doctors sometimes go too far, construing the Hippocratic Oath “as an imperative to do everything for the patient regardless of the cost or effects on others.” McCaughey takes Emanuel’s words and accuses him of wanting “doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else. Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.” McCaughey states that Emanuel believes “medical care should be reserved for the non-disabled, not given to those ‘who are irreversibly prevented from being or becoming participating citizens…’ Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.” She also claims that Emanuel “explicitly” advocated denying health care to senior citizens in favor of providing treatment to younger patients. McCaughey claims that both Emanuel and Dr. David Blumenthal, the White House’s national coordinator of health information technology, favor “slowing medical innovation to control health spending” and denying patients access to advanced medical technology. According to McCaughey, Blumenthal also favors letting “computers tell… doctors what to do.” She concludes: “No one has leveled with the public about these dangerous views.… Do we want a ‘reform’ that empowers people like this to decide for us?” [Wall Street Journal, 7/23/2009; New York Post, 7/24/2009] A White House official later notes that McCaughey misrepresented Emanuel’s writings, and that Emanuel was describing positions and beliefs that he opposed in the same articles. ABC News’s Jake Tapper will note that Emanuel’s fellow doctors and medical ethicists know him as a fervent advocate of the rights of dying patients. [ABC News, 7/28/2009] And Emanuel himself will rebut McCaughey’s claims (see August 12, 2009). McCaughey’s previous claims about the dangers of health care reform, including her assertion that reform would encourage doctors to let senior citizens die, have been roundly debunked (see July 23, 2009).

Entity Tags: New York Post, Elizabeth (“Betsy”) McCaughey, David Blumenthal, Ezekiel Emanuel, Jake Tapper, Wall Street Journal, Federal Council on Comparative Effectiveness Research, Obama administration, Office of Management and Budget

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Slate reporter and columnist Christopher Beam coins a new term, “deathers,” to label conservatives who are spreading the debunked rumors that President Barack Obama’s health care proposals would kill old people (see July 16, 2009 and July 23, 2009). Beam publishes his article on the same day that Representative Virginia Foxx (R-NC) claims that under Obama’s reforms, seniors would be “put to death” (see July 28, 2009), and that Obama holds a “town hall” meeting where he debunks this and other rumors surrounding his proposals (see July 28, 2009). The claim apparently originated with lobbyist and lawyer Betsy McCaughey (see November 23, 2008, January 27, 2009, February 9, 2009, February 11, 2009, February 18, 2009, May 13, 2009, June 24, 2009, June 25, 2009, July 16, 2009, and July 23-24, 2009), who used similarly questionable claims to derail the 1994 reform proposals by the Clinton administration (see Mid-January - February 4, 1994). Others have made similar assertions; Representative Paul Broun (R-GA) recently warned that Obama’s reform proposals would “kill people” (see July 10, 2009), and conservative commentator and author Charlotte Allen says: “Obama’s not going to say, ‘Let’s kill them.’ But he seems to be perfectly comfortable with the idea that a lot more old people are going to die a lot sooner.”
End-of-Life Consultations - Beam shows that the language of the bill, as it stands in Congress at this time, provides for “end-of-life consultations” between patients and doctors, if the patients wish them. In those consultations, doctors would explain what kind of services are available to those patients—palliative care and hospices, in-home care, more intensive treatments in a hospital, etc.—but would not tell patients that they had to restrict themselves to less intensive treatments that would shorten their lives. Some “deathers” have also insisted that the bill provides for the withholding of “artificially administered nutrition and hydration.” McCaughey is a vocal proponent of this claim. However, such a choice would have to be made by the patient and/or the family, specifically not a doctor.
Shared Decision-Making - Opponents of health care reform such as McCaughey claim that the House bill would “coerce” seniors into taking part in a program that forces them into making decisions about “trade-offs among treatment options,” or takes the final decision-making power away from them and places it in the hands of doctors or government officials. In reality, the bill would provide an informational tool for patients and families to make informed decisions. No coercion could legally be applied.
Obama Staffers Cause Concern - Some of Obama’s staffers have said and written things that cause consternation among reform opponents (see July 23-24, 2009). One of Obama’s senior health care advisers, Ezekiel Emanuel, who serves as health policy adviser at the White House’s Office of Management and Budget (OMB), wrote in 2008 that doctors too often interpret the Hippocratic oath “as an imperative to do everything for the patient regardless of the cost or effects on others,” leading some to wonder if Emanuel would put cost concerns over patients’ needs; others have gone farther, comparing Emanuel to Nazi doctors and of advocating “eugenics.” In 1977, Obama’s “science czar,” John Holdren, joined two other authors in writing about possible methods of population control, including a speculative bit about sterilizing people by introducing chemicals into the water supply. (ABC News later reports that the controversial passage was from a textbook in which various methods of population control were considered and rejected. Holdren recently released a statement saying that population control is not the government’s job; his statements on the matter passed muster in the Senate Commerce Committee, whose Republican members joined Democrats in unanimously approving his nomination as the director of the White House’s Office of Science and Technology Policy.) And some worry that the proposed Independent Medicare Advisory Council, which would oversee cost containment for Medicare, would be staffed, in Allen’s words, with “a certain class of secularized intellectuals” who might put cost concerns over quality of life. [Slate, 7/28/2009; ABC News, 7/28/2009]

Entity Tags: John Holdren, Charlotte Allen, Barack Obama, Christopher Beam, Ezekiel Emanuel, Senate Commerce Committee, Elizabeth (“Betsy”) McCaughey, Office of Science and Technology Policy, Medicare, Virginia Foxx, Paul Broun

Timeline Tags: US Health Care, Domestic Propaganda, 2010 Elections

Dr. Ezekiel Emanuel, a senior health care adviser in the Obama administration, rebuts claims that he is a “deadly doctor” who advocates wholesale euthanasia for America’s senior citizens (see July 23-24, 2009, July 28, 2009, and August 7, 2009). Emanuel, a medical ethicist, does not own a television or have an Internet connection and so remained unaware of the accusations about his medical beliefs for weeks. “I couldn’t believe this was happening to me,” he says. Both Emanuel and Time reporter Michael Scherer point out that Emanuel has worked throughout his career to oppose euthanasia and increase care for dying patients. “It is incredible how much one’s reputation can be besmirched and taken out of context,” Emanuel says. Scherer notes that the New York Post op-ed by Betsy McCaughey (see July 23-24, 2009) used “selective and misleading quotes from Emanuel’s 200 or so published academic papers,” and soon “went viral” on the Internet and among conservative opponents of health care reform. Scherer writes: “The attacks on Emanuel are a reminder that there is a narrow slice of Americans who not only don’t trust government, but also have come to regard it as a dark conspirator in their lives. This peculiar brand of distrust helps create the conditions for fast-moving fear-mongering, especially on complex and emotionally charged topics like the life and death of the elderly and infirm.” Scherer notes that throughout his career, Emanuel has wrestled with the ethics of medical care, often wading into horrific hypothetical situations such as how to choose who gets a single kidney if there are three dying patients in need of it and no way to procure two others. “No one who has read what I have done for 25 years would come to the conclusions that have been put out there,” says Emanuel. [Time, 8/12/2009]

Entity Tags: Obama administration, Ezekiel Emanuel, Michael Scherer, Elizabeth (“Betsy”) McCaughey

Timeline Tags: US Health Care, Domestic Propaganda

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